Equity focused health impact assessment Dr Ben Harris-Roxas, Deputy Director Centre for Health Equity Training, Research and Evaluation (CHETRE) The Role of the Health System in Reducing Health Inequity Wednesday 29 June
Feb 17, 2017
Equity focused health impact assessmentDr Ben Harris-Roxas, Deputy Director
Centre for Health Equity Training, Research and Evaluation (CHETRE)
The Role of the Health System in Reducing Health Inequity
Wednesday 29 June
Purpose of this session
• Overview of equity focused health impact assessment (EFHIA)
• Examples of EFHIAs• Effectiveness of EFHIAs – what works• Opportunities, barriers and considerations within health
systems
Equity Focused Health Impact Assessment
Considering equity: Differential impacts
Considering equity: Determinants of health inequity
Source: Harris E, Harris-Roxas B (2010) Health in All Policies: A pathway for thinking about our broader societal goals, Public Health Bulletin South Australia, 7(2): 43-46.
Example: VicHealth EFHIA of the Walk to School Program 2016
Example: EFHIA of the Aboriginal Good for Kids, Good for Life Program Activities
Example: NSW Australian Better Health Initiative Implementation Plan EFHIA
Source: Harris-Roxas B, Harris P, Harris E, Kemp L (2011) A Rapid Equity Focused Health Impact Assessment of a Policy Implementation Plan: An Australian case study and impact evaluation, International Journal for Equity in Health, 10(6).
What works• Structured process• EFHIA as a process for
learning– Technical– Conceptual– Social
• Timeliness• Identifying assumptions*• Equity has cross-sectoral
relevance*
What doesn’t• Equity adds an additional layer
of conceptual complexity*• Lack of a shared
understanding about the goals of the EFHIA
• Lack of organisational commitment
• Challenging values and differential impacts*
Effectiveness: What works an what doesn’t
* Both enablers and barriers depending on context
The overarching challenge
Discussion
• Your experience and insights
• What are the opportunities for EFHIA’s use?
• What are the challenges?
• Are there related approaches we should be considering?
• Is there a role of EFHIA in the health system?
Strategies/actions/ideas from the workshop• It is possible to incorporate EFHI into planning at LHD/state level but
• needs champions• needs to be regarded as core business.
• Transparency/trade-offs within EFHIAs aren’t straightforward• often take the form of short term pain for long term gain.
• An activity that would advance EFHIA/health equity more generally• identify the prevention activities where equity gains can be made or where there
are gaps• don’t focus solely on intractable issues or solely on greatest need, think about
where change can occur as well.• EFHIA should be considered a tool for “bringing together narratives and
numbers”• demonstrating need/relevance at a practical/local/implementation/narrative level
and aligning with population/macro/numbers level.• Is there a role for Equity Focused Health System Impact Assessment?
• this would also be about recognising where we can make gains.